In this report, we describe a case involving a 34-year-old woman who showed good treatment outcomes with long-term stability after multidisciplinary treatment for unilateral cleft lip and palate (CLP), maxillary hypoplasia, severe maxillary arch constriction, severe occlusal collapse, and gingival recession. A comprehensive treatment approach was developed with maximum consideration of strong scar constriction and gingival recession; it included minimum maxillary arch expansion, maxillary advancement by distraction osteogenesis using an internal distraction device, and mandibular setback using sagittal split ramus osteotomy. Her post-treatment records demonstrated a balanced facial profile and occlusion with improved facial symmetry. The patient's profile was dramatically improved, with reduced upper lip retrusion and lower lip protrusion as a result of the maxillary advancement and mandibular setback, respectively. Although gingival recession showed a slight increase, tooth mobility was within the normal physiological range. No tooth hyperesthesia was observed after treatment. There was negligible osseous relapse, and the occlusion remained stable after 5 years of post-treatment retention. Our findings suggest that such multidisciplinary approaches for the treatment of CLP with gingival recession and occlusal collapse help in improving occlusion and facial esthetics without the need for prostheses such as dental implants or bridges; in addition, the results show long-term post-treatment stability.
Adult ; Cicatrix ; Cleft Lip* ; Constriction ; Dental Implants ; Esthetics ; Female ; Gingival Recession* ; Humans ; Hyperesthesia ; Lip ; Osteogenesis, Distraction* ; Osteotomy, Sagittal Split Ramus* ; Palatal Expansion Technique ; Palate* ; Prostheses and Implants ; Recurrence ; Tooth ; Tooth Mobility

PURPOSE: The purpose of this study is to compare and analyze the shear bond strength and fracture pattern in different enamel tooth surface treatments for resin splinting materials. MATERIALS AND METHODS: G-FIX and LightFix were used as tooth splinting materials. Twenty bovine mandibular incisors were used for the preparation of the specimens. The exposed enamel surface was separated into four parts. Each tooth was treated with 37% phosphoric acid, 37% phosphoric acid + adhesive resin, 37% phosphoric acid + G-premio bond, and G-premio bond for each fraction. Shear bond strength was measured using a universal testing machine. After measuring the shear bond strength, the fractured surface of the specimen was magnified with a microscope to observe the fracture pattern. Two-way ANOVA was used to verify the interaction between the material and the surface treatment method. Oneway ANOVA was used for comparison between the surface treatment methods of each material and post-hoc test was conducted with Scheffe's test. An independent t-test was conducted to compare shear bond strengths between materials in each surface treatment method. All statistics were conducted at 95% significance level. RESULTS: G-FIX, a tooth splinting resin, showed similar shear bonding strength when additional adhesive resins were used when material was applied after only acid etching, and LightFix showed the highest shear bonding strength when additional adhesive resins were used after the acid etching. In addition, both G-FIX and LightFix showed the lowest shear bond strength when only self-etching adhesive was applied without additional acid etching. Verification of interactions observed interconnection between resins and surface treatment methods. Most of the mixed failure was observed in all counties. CONCLUSION: When using G-FIX and LightFix, which are tooth-splinting materials, it is considered that sufficient adhesion will be achieved even after applying only acid etching as instructed by the manufacturer.
Adhesives ; Dental Enamel ; Incisor ; Methods ; Splints ; Tooth Mobility ; Tooth

The purpose of this study was to analyze the dental consultation of pediatric inpatients to the department of pediatric dentistry in Yonsei University Severance Hospital, and to investigate the change in patterns. In 2017, 268 pediatric patients (384 cases) admitted to the Severance Hospital were referred to the department of pediatric dentistry. The mean age was 6.6 years, and most of the patients were referred from the Department of Pediatric Hematology Oncology and Rehabilitation Medicine. The chief complaints were as follows: oral examination (31%), dental caries (20%), oral pain (10%), tooth mobility (10%), pre-operative evaluation (9%) and others (20%). 41% of the patients received only oral examination without treatment. Dental caries were the most frequent dental diagnosis of the patients. 28% (111 cases) of patients received operative treatments, 22 cases were treated under general anesthesia. Oral health is closely related to systemic diseases, especially for hospitalized patients. Dental consultations should be encouraged for prevention and early appropriate treatments. For this purpose, it is necessary to establish a referral system and perform dental treatment under general anesthesia.
Anesthesia, General ; Dental Caries ; Diagnosis ; Diagnosis, Oral ; Hematology ; Humans ; Inpatients ; Oral Health ; Pediatric Dentistry ; Referral and Consultation ; Rehabilitation ; Tooth Mobility

PURPOSE: The purpose of this study was to compare flexural strength and elastic modulus of several splinting materials dependent on water absorption. MATERIALS AND METHODS: Three different materials; LightFix, G-FIX, G-aenial Universal Flo; were used in this study. Thirty rectangular bar specimens (25 × 2 × 2 mm) of each materials were prepared. Fifteen specimens of each materials were stored in 100% relative humidity atmosphere, 37℃ for 24 hours. The other specimens were stored in distilled water, 37℃ for 30 days. Flexural strength and elastic modulus were calculated using Universal testing machine. One-way ANOVA and Scheffe's post hoc test at 95% level of significance were used on all test results. RESULTS: In LightFix, flexural strength and elastic modulus were significantly decreased after aging. In G-FIX, there was no significant change in flexural strength and elastic modulus after aging. In Gaenial Universal Flo, flexural strength was significantly decreased, but elastic modulus did not change significantly. Statistical analysis reveals that flexural strength and elastic modulus increased in the order of LightFix, G-FIX, G-aenial Flo in both 24 hours and 30 days. CONCLUSION: It could be deduced from this study that flexural strength and elastic modulus of some resins could be changed when it aged in oral environment. Thus this should be considered when choosing a resin to perform a resin-bonded splint.
Absorption ; Aging ; Atmosphere ; Elastic Modulus ; Humidity ; Splints ; Tooth Mobility ; Tooth ; Water

PURPOSE: The aim of this study was to evaluate the polymerization ability of resin-based materials used for teeth splinting according to the thickness of cure. MATERIALS AND METHODS: For this study, the Light-Fix and G-FIX developed for resinous splinting materials and the G-aenial Universal Flo, the high-flowable composite resin available as restorative and splinting material, were used. Ten specimens of the thickness of 2, 3, 4 and 5 mm and 5 mm in diameter for each composite resin (total 120) were prepared. The microhardness of top and bottom surfaces for each specimen was measured by the Vickers hardness testing machine. The polymerization ability of the composite resin for each thickness was statistically analyzed using independent T-test at a 0.05 level of significance. RESULTS: There was no difference of polymerization ability regardless of the thickness in the Light-Fix and G-FIX. The G-aenial Universal Flo showed significantly low polymerization ability from the thickness of the 3 mm (P < 0.05). CONCLUSION: The Light-Fix and G-FIX, which are resin-based materials used for teeth splinting, are expected to be suitable for light curing up to 5 mm in thickness.
Hardness Tests ; Polymerization ; Polymers ; Splints ; Tooth Mobility ; Tooth

Arteriovenous malformation (AVM) of the mandible is a rare vascular condition that can manifest as a wide range of symptoms and, on rare occasions, cause fatal hemorrhage. The symptoms of mandibular AVM can range from soft tissue swelling and tooth mobility to severe hemorrhage. The recognition of early symptoms is crucial for the prevention of a fatal hemorrhage and for the proper diagnosis and treatment of mandibular AVM. For emergency hemostasis of a ruptured mandibular AVM, manual compression with gauze, topical thrombin, absorbable hemostat, suturing the lesion, and replanting the extracted tooth is recommended. Multiple treatment options for mandibular AVM are available, such as arterial embolization, venous embolization, direct surgical closure, and bone resection. A combination of treatment options should be considered in complicated cases. We report a case of a 10-year-old girl with a previous history of telangiectasia on the right cheek presented with cardiac arrest resulting from massive bleeding immediately after a tooth extraction.
Arteriovenous Malformations ; Cheek ; Child ; Diagnosis ; Emergencies ; Female ; Heart Arrest ; Hemorrhage ; Hemostasis ; Humans ; Mandible ; Telangiectasis ; Thrombin ; Tooth ; Tooth Extraction ; Tooth Mobility

The direct metal laser sintering (DMLS) technique would be promising for the full-arch implant-supported restorations due to reduced cost and manufacturing time without potential human errors and casting defects. The aims of this case report were to describe the successful outcome of an implant-supported fixed dental prosthesis in the edentulous maxilla by using the DMLS technology and computer-aided design and computer-aided manufacturing (CAD/CAM) monolithic zirconia crowns, and to describe its clinical implications. A healthy 51-year-old Korean woman visited Seoul National University Dental Hospital and she was in need of a rehabilitation of her entire maxilla due to severe tooth mobility. In this case, all maxillary teeth were extracted and an implant-supported fixed dental prosthesis was fabricated that involved a cobalt-chromium (Co-Cr) framework with the DMLS technique and CAD/CAM monolithic zirconia crowns. Six months after delivery, no distinct mechanical and biological complications were detected and the prosthesis exhibited satisfactory esthetics and function. In this case report, with the DMLS system, the three-dimensional printed prosthesis was created without additional manual tooling and thus, reliable accuracy and passive fit were obtained.
Computer-Aided Design ; Crowns ; Dental Prosthesis ; Esthetics ; Female ; Humans ; Maxilla* ; Middle Aged ; Prostheses and Implants ; Rehabilitation* ; Seoul ; Tooth ; Tooth Mobility

PURPOSE: The aim of this study is to evaluate the flexural strength of flexible resins and the flexibility of different resin splint (RS) systems in comparison with resin wire splint (RWS) system. MATERIALS AND METHODS: Three different resin materials (G-aenial flo, GA, GC; Superbond, SB, Sun medical; G-fix, GF, GC) were tested flexural strength test in accordance with ISO-4049:2000. For the flexibility test of splint systems, a artificial model with resin teeth was used to evaluate three types of resin splint systems (GA, SB, and GF) and one resin wire splint system. The left central incisor was simulated ‘injured teeth’ with third degree mobility. Three consecutively repeated measurements of periotest value were taken in horizontal direction, before and after splinting to access tooth mobility. The splinting effect was calculated through the periotest value. Differences were evaluated through One-way Anova and Tukey HDS post-hoc tests for pair-wise comparison (α= .05). RESULTS: Although GA group showed significant higher flexural strength than SB and GF groups, all of three different resin splint systems produced a significantly higher and rigid splinting effect compared with 016" resin-wire splint system (P < .05). CONCLUSION: Within the limits of an in vitro study, it can be stated that resin splint systems are too rigid and may not be acceptable to treat tooth avulsion.
In Vitro Techniques ; Incisor ; Pliability* ; Solar System ; Splints* ; Tooth Avulsion ; Tooth Mobility ; Tooth*

PURPOSE: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. METHODS: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. RESULTS: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. CONCLUSIONS: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.
Bicuspid* ; Dental Implants* ; Dental Implants, Single-Tooth ; Follow-Up Studies* ; Humans ; Incidence ; Molar ; Periodontal Ligament ; Retrospective Studies ; Splints ; Tooth ; Tooth Mobility

PURPOSE: This article describes a case of the successful non-surgical management of a periodontally compromised maxillary premolar. METHODS: A combination therapy, including root planing, occlusal adjustment, and tooth splinting, was applied. Clinical and radiographic examinations were performed during the 16-month follow-up period. RESULTS: All periodontal parameters were improved. There were dramatic decreases (3–6 mm) in the probing pocket depth, tooth mobility, and marginal bone loss. Interestingly, gradual resolution of the periapical radiolucency and alveolar bone regeneration were observed in the radiographs, and the periodontal condition was maintained during the follow-up period. CONCLUSIONS: Within the limits of this study, these results demonstrate the importance of natural tooth preservation through proper periodontal treatment and occlusal adjustment of the periodontally compromised tooth, which is typically targeted for tooth extraction and dental implantation.
Bicuspid ; Bone Regeneration ; Dental Implantation ; Dental Implants ; Dental Occlusion, Traumatic ; Follow-Up Studies ; Occlusal Adjustment ; Periodontitis ; Root Planing ; Splints ; Tooth Extraction ; Tooth Mobility ; Tooth*